Overview of ABCD III Evaluation Strategies and Findings · Overview of ABCD III Evaluation...
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Overview of ABCD III Evaluation Strategies and Findings June 24, 2013 Carrie Hanlon Program manager, NASHP [email protected] 1
Transcript of Overview of ABCD III Evaluation Strategies and Findings · Overview of ABCD III Evaluation...
Overview of ABCD III Evaluation Strategies and
Findings
June 24, 2013
Carrie Hanlon Program manager, NASHP
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Overview
l How did ABCD IIII states work to improve care coordination?
l What did states measure? l How did they measure? l What were their results? l What are the key takeaways?
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ABCD III states
NH MA
ME
NJ CT RI
DE
VT
NY
DC MD
NC
PA
VA WV
FL
GA SC
KY
IN OH
MI
TN
MS AL
MO IL
IA
MN WI
LA
AR OK
TX
KS
NE
ND
SD
HI
MT
WY
UT
CO
AK
AZ NM
ID OR
WA
NV CA
PR
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Improvement Strategies
l Consistent forms, tools, processes l Primary care provider incentives l Continuous quality improvement l Data system enhancement or development l Community engagement l Integration of lessons into state reform
initiatives
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Evaluation
l Expectations of state participation: l Evaluation plan l Common outcome
l States selected “closed feedback loop” l State-specific measures
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Closed Feedback Loop
l Each state’s project focused on affecting the following points of the care delivery process: l PCP referral to local community service provider
after identification of patient risk via a screening; l Community service provider follow up (with
referral feedback) to referring PCP; and l Documentation of referral feedback in the PCP
chart or by the PCP (a “closed loop.”)
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Closed Feedback Loop Measures l Number of Medicaid/CHIP children referred for developmental
services whose PCP knows the results of the referral (AR)
l Number of referrals EI responded to by using referral fax-back form sent to referring medical home (IL)
l Number of children ages 0-2 referred to EI for whom the eligibility status was known and marked in the child’s electronic medical record at the referring clinic (MN)
l Number of children ≤ 34 months of age referred for EI services whose PCP knows of the services received within 80 days (OK)
l Number of children referred to EI, whose PCP received feedback from EI that was incorporated into the chart (OR)
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State-specific Measures l Stakeholder experience
l Parents/families l Medical providers l EI providers l Other community providers
l Developmental screening l Referral rate l Timeliness
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Measurement Methods l Closed feedback loops:
l Chart review l Claims analysis l Data tracking tools completed by providers
l State-specific measures: l All of the above, plus
l Surveys l Interviews l Community meetings
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Closed Feedback Loops at Baseline
l Missing (no system in place to track feedback information) in 2 states (IL, OK)
l Moderate rates of feedback in 3 states l 53% (AR) l 64% (MN) l 60% (OR, mid-project)
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Post-Intervention Rate of Closed Loops l 88% (compared to 53%) in AR l 66% in IL l 68% (compared to 64%) in MN** l 78% in OK
**Measure changed, which may have affected results
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Timeliness: Time Needed to Close the Loop
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Takeaways l Mechanism likely needs to be created to track
referral feedback l ABCD III states documented improvement in
tracking and in some cases, closed loops l Measuring multiple aspects of the care process
helps prioritize QI efforts l EHRs need capacity to track referral feedback
and consent forms l Multi-method strategies are valuable l Incentives facilitated evaluation
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Thank You
l Look for the report on www.nashp.org l Improving and Measuring Care Coordination:
Lessons from ABCD III
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